妊娠高血压综合征胎盘中细胞增殖核抗原与肿瘤坏死因子表达的研究

Study on expression of PCNA and TNF-α in placenta and their correlation in pregnancy-induced hypertension

目的研究妊娠高血压综合征患者胎盘组织中TNF-α表达、胎盘增殖状况及其相互关系。方法采用SABC法对轻、中、重度妊娠高血压综合征共30例和正常妊娠组10例的胎盘组织进行TNF-α和PC-NA的免疫组化染色。分析各组TNF-α、PCNA的表达量,计算PCNA阳性细胞/总细胞比值,并对该比值和TNF-α表达量进行等级相关分析。同时常规HE染色观察胎盘形态学变化。结果妊娠高血压综合征胎盘中TNF-α和PCNA的表达量、PCNA阳性细胞/总细胞值明显高于对照组,并随病情加重而升高。PCNA阳性细胞主要是细胞滋养细胞和细小血管平滑肌细胞等。PCNA阳性细胞/总细胞和TNF-α含量之间存在显著正相关关系(r=0.628,P<0.05)。结论妊娠高血压综合征时胎盘中存在特定细胞的增殖升高,并参予了妊娠高血压综合征的病理生理机制。这种增殖可能是TNF-α通过某些途径直接或间接作用的结果,也可能有对损伤的代偿性反应。

[Objective] To study proliferating condition of placenta in pregnant women with PIH and its correlation with TNF-α as well. [Methods] Immunohistochemistry was employed on three groups of PIH （30 cases in total） and control group （10 cases） to show the expression of PCNA and TNF-α in placenta. Density of PCNA and TNF-α in each group was analyzed. The ratio of PCNA positive cells to all was calculated, and Spearman rank correlation was done between the ratio and the level of TNF-α. Morphologic changes of placenta in each group were also observed by means of HE staining. [Results] The level of TNF-α and PCNA, the ratio of PCNA（＋） cells in placenta of PIH were all significantly higher than control group. PCNA （＋） cells were ma;nly cytotrophoblastic cells, smooth muscle cells, ect. There was a very significant positive correlation between the ratio of PCNA（＋） cells and the level of TNF-α （r =0.628, P 〈0.05）. [Conclusion] Proliferation of particular types of cells in placenta is enhanced in preeclampsia, which may play an important role in the development of PIH. This proliferation may be a compensatory reaction to damage caused by TNF-α or an effect of TNF-α through some direct or indirect ways. However, the exact relationship between them and the mechanism in detail are still unknown and need further research.